Drugs that cause an increase in adverse drug reactions in the older patient

Unless medicines are properly managed they can cause serious harm. Older patients - amongst whom swallowing difficulties are common - are at especially high risk of developing ADRs due to a number of interlinked factors including co-morbid conditions, including heart failure, hypertension, renal failure, chronic obstructive lung disease and diabetes. Older patients also often receive multi-drug therapy, which increases the likelihood of interactions and non-compliance.

An adverse drug reaction can be defined as: "Any response to a drug that is noxious and unintended and that occurs at doses used in man for prophylaxis, diagnosis or therapy." 

The general consensus resulting from research into the area of adverse drug reactions in the older patient is that the majority of adverse reactions are caused by a limited range of drugs.

Common medication causes of adverse drug reactions in the older patient

• Hypotensives including diuretics          21%
• Rigidity and tremor controllers              13%
• Corticosteroids                                     12%
• Antidepressants and tranquilisers        12%
• Digoxin                                                   11%
• Insulin and hypoglycaemics                    9%
• Hypnotics and sedatives                         7%
• Analgesics and antipyretics                    5%
• Others                                                     5%
• Antibiotics and antibacterials                  4%

(Greenwall, 2003)

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